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HomeMy WebLinkAboutMP24-069 b fq Ln y a '~ cn W W v _ a ,cn 0.0 C v ©cn W on W O r- W V 00 Cc) v , W W © o W x J cb u a o Q" O F� z © A U G1 o o � " � w U : F—� �i I�i M W W C�7 vs •o Q z u00 w a v -v w 0.0 W 0-+ A F-+ a d a a 0 x 04q -00 a a a GGG F-+ w po4v �v W Q o O z O O2 . o 1 O O -O (� mz.- 1� V V � W I 0 L z H A p A O > ° x a a � BUILD -. - MENT L, �W L V EOF RY OOK 938 KtN ET RYE BR:� ,NY 10573 JUN - 4 2024 4 0 VILLAGE OF RYE BROOK BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE USE ONLY: PERMIT#: ! lLoc)q Approval Date: Permit Fee: Approval Signature: Other: .// 00 S� G /6 n Disapproved: (fees are non-refundable) ****,k**ir*,t,rs********r*,r**xx*r,r xarr,rr*ir**ot,t*,tdr***tc,t,t�**�*,t,k*+t*****�r,r*+t,t****,t*t*+t+t*:****a**.t**,t�rrt**,►,rsr*** DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BV THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT 1S 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 REQUIREMENTS FOR RELEASE OF PERMIT_ &CERTIFICATE OF COMPLIANCE. I. Properly completed & Signed Application. 2_ Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance. (village of Rye Brook trust be listed as certificate holder) & Workers Compensation Insurance on a NYS Board form (Form#C 105.2 or Fonn#U26.3 I or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL=$100.00/unit• COMMERCIAL=$350.00/unit. 5. Complete specifications for each unit being installed. 6. Inspection by the Building Department for removal and/or installation. (48 hour notice required) 7. Electrical work requires a separate Electrical Permit& Electrical Inspection. 8. Plumbing/Gas work requires a separate Plumbing Permit& Plumbing Inspection. Application dated, is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County,State&Federal laws, codes, rules and regulations. I. Address: 450 N Ridge St SBL_ 129.68-1-7 zone: R-15 2. Property Owner: Martin Krauss Address: 450 N Ridge St Phone#: 914-939`6998 Cell#: email: Helmar43@msn.com 3. Contractor: Yost & Campbell ; Thomas Monahan Address: 20 Brookdale PI Phone#: 914-668-6461 Cell#: email: Abrown@yostandcampbell.com 4. Scope of Work: New Installation 0()•Replacement( )•Removal( )•Other( ): 5. List Equipment: Replacing old equipment and directly placing 14 seer2, 5 Ton, Air Conditioner, and a Horizontal coil, 4.00 Ton, Evap Coil *please see specs and proposal for details* 6. Location of Equipment: inside and outside the property *please see survey* T Method of Instal lation/Removat(list all equipment needed to perform job): l 10/30/2023 11i11•'2024 11:50AM FAX +9149396998 KRALSS 0001/0001 STATE OF NEW YOLK,COUNTY OF WESTCHESTER ) as: Thomas Monahan ,being duly sworn,deposes and states that he/she is the applicant above named, (print uwne of individual signing as the applicant) and further states that(s)he is the Heating,Ventilation and/or Air Conditioning Contractor for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Cade,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this 11 _ Sworn to before me this day of 20 z'`j -- day of ,) 20_ _ 4Siond4ofroperty Owner Signa re of App icani Martin KraussW Print ame of Property Owner Print lame of Applicant J. otary Public Notary Public LISA FITZGERAL11 LISA FITZGERALD Notary Public, State of New York Notary Public, State of New York Reg No WF16402089 Reg No. 01F164U2U89 Qualified in Puresm r2 23120�'� Qualified in Putnam County Commission ExP Commission Expires 12123/20 P--1 This application must be properly completed in its entirety and ii-itist include the notarized signalurc(s) of the legal owner(s) of the subject property, and the applicant of record in the: spaces provided. Any application Mot properly completed its its entirety told/or not properly signed shall be deemed null and void and will he returned to the applicam. 2 l0130/2023